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Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by infective endocarditis and outlines current and future strategies to limit its impact.

Original publication

DOI

10.1016/j.jacc.2016.10.066

Type

Journal article

Journal

J Am Coll Cardiol

Publication Date

24/01/2017

Volume

69

Pages

325 - 344

Keywords

TAVR, cardiac device infection, infective endocarditis, Aged, Anti-Bacterial Agents, Endocarditis, Equipment and Supplies, Humans, Male, Practice Guidelines as Topic, Stroke